COVID-19 CASE AND MORTALITY RATES IN GREEN HOUSES AND TRADITIONAL NURSING HOMES IN NEW YORK STATE

Introduction. Green Houses (GHs) have features that distinguish them from traditional nursing homes (NHs) including small size, home-like settings, humane model of care, and a sense of community. Literature shows these features have contributed to lower staff turnover, higher resident satisfaction, and lower COVID-19 case and mortality rates. Few studies use longitudinal data to quantify the differences between GHs and NHs by examining COVID-19 case and mortality rates. Methods. Nursing Home COVID-19 Data from CMS were used to compare case and mortality rates between GHs (n=4) and NHs (n=614) from 5/2020 to 1/2022. Case and mortality rates were calculated for GHs and NHs. Incidence rate ratio (IRR) of case and mortality rates were provided. Results. The preliminary results indicate GHs have lower COVID-19 case (3.76 vs. 6.8 per 1,000 resident weeks) and mortality rates (0.35 vs 1.21 per 1,000 resident weeks) compared to NHs. The IRR for COVID-19 cases is significantly higher in NHs compared to GHs (IRR = 1.8;95% CI 1.55, 2.11), likewise, for mortality (IRR = 3.45;95% CI 2.09, 5.75). Conclusions. The findings illuminate key differences in COVID-19 case and mortality rates among GHs and NHs. Factors such as GH size and their unique care model may contribute to the differences observed in COVID-19 case and mortality rates when compared to NHs. Future studies may include facility or resident characteristics in the study design.

Training during the COVID-19 pandemic: the experience of public health registrars in the London and Kent, Surrey, Sussex training programme.

BACKGROUND: Public Health registrars (SpRs) were an important component of the workforce that contributed to the COVID-19 response. This study explores their contribution and the impact the early stages of the pandemic had on their learning and training. METHODS: Data were collected from SpRs in the London and Kent, Surrey, Sussex training programme between July and September 2020 through a mixture of questionnaires and semi-structured interviews. A thematic analysis of interview transcripts was undertaken to identify themes. RESULTS: 35/128 SpRs responded to the survey and 11 were interviewed. SpRs were placed across a range of organizations and made a significant contribution to the COVID-19 response. Overall, SpRs learned important skills but working on the response may for some have impacted negatively on training. A number of facilitators and barriers to learning were identified. CONCLUSION: The study findings highlight the opportunities for learning created by the pandemic. However, changing projects and the desire of SpRs to contribute to the response meant the impacts on training were mixed. Future deployment of SpRs should consider the balance of responsibility and pace when delegating work, as well as the need to supervise effectively and support remote working to maintain good mental wellbeing.

A Cohort Study Investigating the Psychological Correlates of Vigorous Physical Activity Among African-American Adolescent Females

As a result of severe acute respiratory syndrome coronavirus 2, there has been a surge in the prevalence and severity of non-syndromic pediatric overweight (NSPO) in the United States. Prevention interventions such as engagement in regular moderate-to-vigorous physical activity have been consistently shown to mitigate the development and maintenance of NSPO. Yet, African-American adolescent females, a subgroup of the population disparately impacted by NSPO, are less likely to engage in regular physical activity. Although multidimensional global self-concept has been identified as a possible predictor of physical activity engagement, dimensional linkage with physical activity engagement among members of this subgroup has yet to be established. This secondary analysis of data from N = 312 urban dwelling African-American adolescent females sought to evaluate the contribution that selected dimensions of global self-concept had on engagement in vigorous physical activity. Findings from a 3-Model hierarchical regression analysis found that in addition to socioeconomic position, several social desirability and competence dimensions of global self-concept were significant predictive contributors to physical activity engagement among members of the study cohort. Specifically, these were the dimensions of physical appearance, romantic appeal, close friendship, social acceptance, and scholastic competence. Although more research is needed, results from this study have important implications for population health.

Covid-19, Pregnancy, and Vaccinations

Pregnancy in the presence of COVID-19 increases the risk for illness severity. Data suggest that pregnant women with COVID-19 are more likely to be hospitalized, to be admitted to the intensive care unit, and to require life support. Vaccination is currently considered the most effective preventive intervention against COVID-19 in the United States. However, the unsurprising exclusion of pregnant women as participants in initial COVID-19 vaccine clinical trials has led to a gap in the scientific data regarding the safety profile and subsequent use of COVID-19 vaccine for women who are pregnant. Experts believe current COVID-19 vaccines developed using either mRNA or viral vector vaccine technologies and authorized for emergency use by the United States Food and Drug Administration are unlikely to pose obstetrical or neonatal risks. Still, current vaccination recommendations for women who are pregnant have been both mixed and contradictory. The need to expeditiously identify, collate, and disseminate available vaccine-related safety data is critical to preventing severe illness while also advancing the health and wellness of an underserved high-risk population subgroup.

State-level social safety nets for families coping with job loss

Critics of the modern American welfare state allege that safety net benefits discourage work by providing sufficient resources to replace earned income. Yet, research in social policy has long depicted the US safety net as parsimonious and inadequate relative to its European counterparts, even when considering benefits from programs that reward favorable work histories. Other theories predict variability across states and regional clustering even amid low overall spending. Moreover, the recent COVID-19 outbreak has exposed the insufficiency and lack of resilience of the major US safety nets in the face of unprecedented unemployment. This study examines the benefit expenditures on three safety net programs available to American families with recently unemployed breadwinners—Temporary Assistance for Needy Families, Supplemental Nutrition Assistance Program, and Unemployment Insurance—as a proportion of median annual income for a given state-year between 1997 and 2017. We examine the overall spending as well as variability and clustering across states. We find that the average benefit expenditure comprises only 42% of median income, and while there is substantial variability around this average, only one state is above 78%. We also find that spending levels appear to be regionally clustered. We conclude that safety nets for the recently unemployed and their families are weak relative to earned income and that the extent of this weakness varies by state, with some regional patterning. © 2021 Policy Studies Organization

Chloroquine and Hydroxychloroquine for the Treatment of COVID-19: Review and Appraisal of Current Evidence

Novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and associated coronavirus disease 19 (COVID-19) began ravaging most of the globe in November 2019. In the United States more than 25 million people have been infected with SARS-CoV-2. To date, COVID-19 has killed close to 400,000 U.S. citizens. In the face of limited pharmacotherapies, the current burden of SARS-CoV-2 and COVID-19 signals overwhelming sickness and trillions in healthcare costs ahead. The need to expeditiously identify safe and efficacious prophylaxis and treatment options is critical. Drug repositioning may be a promising strategy toward mitigating the impact of SARS-CoV-2 and COVID-19. This rapid review appraises available evidence on the viability of vintage antimalarial drugs chloroquine (CHQ) and its analog hydroxychloroquine (HCQ) repositioned for SARS-CoV-2 prophylaxis and COVID-19 treatment. Findings suggest neither the use of CHQ nor HCQ singularly, or concomitantly, with azithromycin and/or zinc provide definitive benefits for use against SARS-CoV-2 infection or COVID-19 illness. Moreover, administration of these medications was linked to significant and sometimes fatal complications.